Gastroenteritis in an adult female revealing hemolytic uremic syndrome: Case report

Abstract

Nowadays acute gastroenteritis infection caused by Escherichia coli (E. coli) O157:H7 is frequently associated with hemolytic uremic syndrome (HUS), which usually developed after prodromal diarrhea that is often bloody. The abdominal pain accompanied by failure kidney is a suspicious symptom to develop this disorder. Their pathological characteristic is vascular damage which manifested as arteriolar and capillary thrombosis with abnormalities in the endothelium and vessel walls. The major etiological agent of HUS is enterohemorragic (E coli) strain belonging to serotype O157:H7. The lack of papers about HUS associated to gastroenteritis lead us to report this case for explain the symptoms that are uncommon. Furthermore, this report provides some strategies to suspect and make an early diagnosis, besides treatment approach to improving outcomes and prognosis for patients with this disorder.

Keywords: Escherichia coli O157; Gastroenteritis; Gastrointestinal hemorrhage; Hemolytic-uremic syndrome; Shiga-toxigenic Escherichia coli.

Figure 1

Tridimensional structure of Shiga toxin. Shiga toxins are a family of related toxins with two major groups, Stx1 and Stx2, expressed by genes considered to be part of the genome of lambdoidprophages. The most common sources for Shiga toxin are the bacteria S. dysenteriae and the shigatoxigenic serotypes of Escherichia coli, which includes serotypes O157:H7, O104:H4, and other enterohemorrhagic E. coli.